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. 2021 Oct 21;13(21):5294.
doi: 10.3390/cancers13215294.

Tumor Size >5 cm and Harvested LNs <12 Are the Risk Factors for Recurrence in Stage I Colon and Rectal Cancer after Radical Resection

Hye-Sol Jung  1 , Seung-Bum Ryoo  1   2   3 , Han-Ki Lim  1   2 , Min Jung Kim  1   2   3 , Sang Hui Moon  1 , Ji Won Park  1   2   3 , Seung-Yong Jeong  1   2   3 , Kyu Joo Park  1
Affiliations

Tumor Size >5 cm and Harvested LNs <12 Are the Risk Factors for Recurrence in Stage I Colon and Rectal Cancer after Radical Resection

Hye-Sol Jung et al. Cancers (Basel). .

Abstract

Recurrence can still occur even after radical resection of stage I colorectal cancer (CRC). This study aimed to identify subgroups with a high risk for recurrence in the stage I CRC. We retrospectively reviewed prospectively collected data of 1952 patients with stage I CRC after radical resection between 2002 and 2017 at our institute. 1398 (colon, 903 (64.6%), rectum, 495 (35.4%)) were eligible for analysis. We analyzed the risk factors for recurrence and survival. During the follow-up period (median: 59 months), 63 (4.6%) had a recurrence. The recurrence rate of rectal cancer was significantly higher than that of colon cancer (8.5% vs. 2.3%). Left-sided tumors, T2, tumor size >5 cm, and lymphovascular invasion were independent risk factors of colon cancer recurrence. Male, preoperative carcinoembryonic antigen (CEA) ≥2.5 ng/mL, and harvested lymph nodes (LNs) <12 were independently associated with recurrence of rectal cancer. Recurrence affected OS (5-year OS: 97.1% vs. 67.6%). Despite curative resection, survival sharply decreased with recurrence. The risk factors for recurrence were different between colon and rectal cancer. Patients with a higher risk for recurrence should be candidates for more aggressive surveillance, even in early-stage CRC.

Keywords: recurrence; risk factors; stage I colorectal cancer; survival.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Kaplan–Meier curves for survival analysis with stage I colorectal cancer patients. The overall survival according to tumor location (A) and recurrence (B). (A) Colon vs. rectum, (B) no recurrence vs. recurrence.
Figure 2
Figure 2
Kaplan–Meier curves for survival analysis with stage I colon cancer patients. The overall survival according to tumor size (A) and the presence of lymphovascular invasion (LVI) (B). (A) Size ≤ 5 cm vs. Size > 5 cm, (B) Lymphovascular invasion.
Figure 3
Figure 3
Kaplan–Meier curves for survival analysis with stage I rectal cancer patients. The overall Scheme 2.5 ng/mL vs. (A) CEA level ≥2.5 ng/mL, (B) harvested lymph nodes ≥12 vs. <12.
See this image and copyright information in PMC

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